Brian Martinez Email & Phone Number

Florida, United States

Miami/Fort Lauderdale Area

Conduct training and workshops on claims management system & investigative toolsEnsure there is high organizational claims qualityProvide detailed analysis of the claims handled by the claims adjustersProvide feedback on any areas of opportunity for timeliness, accuracy, and documentation. Focus on reduction of severityParticipate in at least one.

Miami/Fort Lauderdale Area

 Review claims and prepare dispositions on those claims that are scheduled for an Examination Under Oath(EUO) Conduct investigative searches such as ISO, Accurint, internet search, to fully prepare for the Examination Under Oath Ask a series a questions to both claimants and insureds regarding coverage, the policy application, injuries, treatment, facts.

Miami/Fort Lauderdale Area

 Reviewed claims and determined coverage issue(s) Processed payments, litigated claims, and settled claims pre-suit Answered interrogatories, attended depositions and attended trials as an expert witness Oversaw 8 individuals within the unit to ensure quality control Maximized output performance and stimulated motivation Provided recommendations on.

Miami/Fort Lauderdale Area

 Reviewed, negotiated and settled claims Qualified claimants/insured’s for coverage amongst many states Licensed to adjust claims in many states including but not limited to Texas Reviewed demands for payment or possible settlement Reviewed vehicle estimates/photos Determined liability based on investigation findings Used tools such as ISO.

Miami/Fort Lauderdale Area

 Reviewed claims and determined coverage issue(s) Processed payments, litigated claims, and settled claims pre-suit Answered interrogatories, attended depositions and attended trials as an expert witness Printer troubleshooting, scanner installation, scanner troubleshooting, operating system troubleshooting, software troubleshooting, and network.

Miami/Fort Lauderdale Area

 Examined and evaluated claims for payment Approved or denied claims as appropriate Initiated payment actions and made adjustment to bills/CPT codes if applicable Investigated claims for compensability, potential subrogation and possible fraud Obtained recorded statements and other evidence Obtained second opinion by way of an Independent Medical.

Miami/Fort Lauderdale Area

 Worked hands on with a program, Powertrak, which applies the applicable fee schedule to bills, where applicable. Cross referenced other sources to ensure that the amounts per CPT code were being paid properly.  Corrected any issues within the system that appeared on a claim.  Worked with Guidewire, a claims management system, that was integrated with.

Miami/Fort Lauderdale Area

 Received new claims on behalf of the licensed adjusters within the company for the Personal Injury Protection (PIP) department.  Requested documents such as police reports, contact letters, PIP packages and any documents necessary to properly process the claim. Initial contact to all parties involved in each loss in an effort to obtain as much facts of.

Miami/Fort Lauderdale Area

 Obtained EUOs for the PIP department for numerous claims(qualification, potential fraud and potential coverage issues) Provided a detailed summary of the EUO and sent the summary to the assigned adjuster as well as a copy to imaging  Reviewed all facts on a claim such as bills, attorney mail, notes, etc. in effort to determine how to conduct the EUO.

Bachelors, Supervision And Management

Activities and Societies: Member of the National Society of Leadership and Success

Associate In Science, Computer Information Technology

Associate In Arts In Computer Information Technology, Information Technology

Graduated with an Associate in Arts in Computer Information Technology Graduated with a College Credit Certificate in Information.